GOING PAPERLESS

"This is an opportunity for them to get started if they are kind of sitting on the fence," said Dr. Dan Heslinga, of Kaneohe, who is overseeing the three-year project, "Bridging the Adoption Gap."

The Hawaii Medical Foundation, a nonprofit arm of the Hawaii Medical Association, received $900,000 from the Physicians' Foundation for Health Systems Excellence for the study. The grant was one of 26 awarded across the nation out of 400 applications.

Only one in 10 isle doctors in small private practices is using electronic records, said Heslinga, one of the first doctors in Hawaii to use electronic medical records in his family practice in 1998.

"The small practice doctors are lagging way behind people in big (physician) groups," he said in an interview. "Part of our project is to figure out why this is happening."

He said computerized care management is seen as "the best way to improve care for the vast majority of chronically ill patients."

Dr. Patricia Blanchette, president of the Hawaii Medical Association and its foundation, said in announcing the grant that electric medical records help physicians "more easily access information that is important to managing complex medical problems."

Heslinga said a patient registry will help a doctor manage patients with chronic diseases, such as diabetes, asthma, heart and kidney disease.

"A registry in its simplest form could be a list of patients with diabetes (or other chronic disease), the last time they were seen in the office ... and services they are due for.

"It reminds a doctor while the patient is in the office of things they're supposed to have. It contains all of the patients' records in one program."

He said it will advance care of patients with chronic diseases because a doctor can go to the registry and print out a visit planner for each patient scheduled for the day, with all the services the patient is supposed to be getting and when they are due.

"It's kind of a limited electronic medical record," Heslinga said. "Before, doctors were frantically leaping through the chart for all the information they need."

Sometimes a person with a chronic disease will see the doctor for another reason, such as sore throat, he said. "Without a registry, the doctor is flipping around looking for old records."

He said it is hoped after getting the 100 doctors started with registries that they will eventually go on to electronic medical records.

Full electronic medical record systems, which cost $30,000 to $50,000, replace paper charts, Heslinga said. "There are no paper records in my office."